Christine Jordan Sexton
Access to specialty physicians varies greatly depending on location but there will be an overall shortage of about 3,700 physician specialists by the year 2025 and rural areas will be the hardest hit, a study released Tuesday by the Teaching Hospital Council of Florida and the Safety Net Hospital Alliance shows.
To abate the impending shortage, Florida — which ranks near the bottom in the number of residency training slots to its population — needs to create an additional 13,568 medical residencies slots so medical school graduates can hone their skills in Florida and stay in Florida and ultimately open practices here. Funding for graduate medical education comes from the federal government as well as the state government.
The study was presented at the Senate Health Policy Committee as well as at a press conference outside the Senate chambers.
“We hear all the time there is a physician shortage in Florida and there is but what does that mean for your area …. what does it mean?” Senate Health Policy Committee Chairman Aaron Bean, R-Fernandina Beach, said introducing the study and its author, Tim Dall of IHS Global. “It’s very fascinating.”
Residencies are considered the key to increasing the workforce because physicians generally stay in the state where they complete their residencies. A sampling of 16,600 doctors shows that residencies play a strong role in where physicians ultimately end up practicing. Indeed, 81 percent of doctors who completed their medical school and training in Florida chose to practice in Florida when their residencies were complete.
But two-thirds of physicians who graduate from Florida medical schools have residencies outside the state.
The study shows supply and demand by 11 regions and by a variety of physician specialty. Location wise, the areas of greatest need are generally rural: the 14 counties in Northwest Florida (excluding Escambia, Okaloosa, Santa Rosa and Walton counties); the 16 counties in the Florida heartland; and seven Southwest Florida counties –Charlotte, Collier, DeSoto, Glades, Hendry, Lee and Sarasota.
In terms of physician specialties the study shows there are 19 specialties where there is a moderate to serious shortfall. The most serious deficits are in the areas of psychiatry, general surgery, rheumatology, thoracic surgery, hematology and oncology, pulmonology and critical care, radiology, cardiology. Combined, there is a deficit of about 7,000 physicians in those 19 fields.
Conversely, there are 10 physician specialties with a projected surplus of providers. Leading the list of over-saturated specialists are geriatricians, pediatricians, dermatologists, emergency medical doctors and plastic surgeons. Combined, there is a surplus of about 4,000 physicians in those specialty areas.
Only Miami-Dade County has an overall surplus of medical doctors. However, when broken down by specialty even Miami-Dade will need more psychiatrists, general surgeons, thoracic surgeons and urologists in the next 10 years.
Tim Dall, author of the study, said it is common for the number of doctors to exceed demand in large metropolitan areas.
While residency programs have an impact on the number of physicians and specialists, state Sen. Bill Galvano, R-Bradenton, told members of the Senate Health Care Policy Committee that being a physician once meant having the “golden key” to economic prosperity. Given decreasing reimbursements, high overhead costs and the hassles of dealing with managed care companies, it no longer is the case, he said.
“There are so many reasons why, today, someone would turn away from the profession entirely versus where we were, say, 10 years ago, so as we look at solutions …. we cannot ignore the other issues that are at the heart of the problem,” Galvano said. “You can make as many slots as you want but people aren’t buying it.”
